Differential Diagnosis for Bilateral Forearm Pain
Single Most Likely Diagnosis
- Overuse or Repetitive Strain Injury: This is the most likely diagnosis due to the common occurrence of repetitive strain injuries in individuals who perform repetitive tasks, such as computer work or manual labor, which can lead to bilateral forearm pain.
Other Likely Diagnoses
- Tennis Elbow (Lateral Epicondylitis): A common condition that causes pain on the outer part of the elbow, which can radiate to the forearm, often bilateral in individuals who engage in activities involving repetitive wrist and arm movements.
- Golfer's Elbow (Medial Epicondylitis): Similar to tennis elbow but affects the inner part of the elbow, causing pain that can extend to the forearm, and can be bilateral in nature.
- Cubital Tunnel Syndrome: A condition that involves pressure or stretching of the ulnar nerve, which can cause pain, numbness, and tingling in the forearm, especially if bilateral, indicating a possible systemic or repetitive strain cause.
Do Not Miss Diagnoses
- Acute Compartment Syndrome: A medical emergency that requires immediate attention, characterized by increased pressure within a muscle compartment, leading to severe pain, especially with passive stretch, pallor, poikilothermia, paresthesia, and pulselessness. Although less common, missing this diagnosis can lead to severe consequences, including permanent nerve and muscle damage.
- Vasculitis: Inflammation of the blood vessels that can cause forearm pain among other systemic symptoms. It's crucial not to miss this diagnosis due to its potential for serious complications if left untreated.
Rare Diagnoses
- Forearm Osteomyelitis: A rare infection of the bone in the forearm, which can cause pain, swelling, and redness. It's less common but should be considered, especially in the context of recent trauma or in immunocompromised patients.
- Eosinophilia-Myalgia Syndrome: A rare condition associated with ingestion of contaminated L-tryptophan supplements, leading to severe muscle pain, including forearm pain, among other symptoms.
- Forearm Bone Tumors: Although rare, tumors such as osteosarcoma or Ewing's sarcoma can cause forearm pain and should be considered in the differential diagnosis, especially in the presence of a mass or systemic symptoms like weight loss or fever.